Chapter 9 | Cerebrospinal Fluid Flashcards
The functions of the CSF include all of the following except:
Producing an ultrafiltrate of plasma
The CSF flows through the:
Arachnoid space
Substances present in the CSF are controlled by the:
Blood–brain barrier
What department is the CSF tube labeled 3 routinely sent to?
Hematology
The CSF tube that should be kept at room temperature is:
Tube 2
Even distribution of blood in all tubes
Intracranial hemorrhage
Xanthochromic supernatant
Intracranial hemorrhage
Concentration of blood in tube 1 is greater than in tube 3
Traumatic tap
Specimen contains clots
Traumatic tap
The presence of xanthochromia can be caused by all of the following except:
A recent hemorrhage
A web-like pellicle in a refrigerated CSF specimen indicates:
Tubercular meningitis
Given the following information, calculate the CSF WBC count: cells counted, 80; dilution, 1:10; large Neubauer squares counted, 10.
800
A CSF WBC count is diluted with:
Acetic acid
A total CSF cell count on a clear fluid should be:
Counted undiluted
The purpose of adding albumin to CSF before cytocentrifugation is to:
D. Both A and B
Increase the cell yield
Decrease the cellular distortion
The primary concern when pleocytosis of neutrophils and lymphocytes is found in the CSF is:
Meningitis
Neutrophils with pyknotic nuclei may be mistaken for:
Nucleated RBCs
The presence of which of the following cells is increased in a parasitic infection?
Eosinophils
Macrophages appear in the CSF after:
D. All of the above
Hemorrhage
Repeated spinal taps
Diagnostic procedures
Nucleated RBCs are seen in the CSF as a result of:
Bone marrow contamination
After a CNS diagnostic procedure, which of the following might be seen in the CSF?
D. All of the above
Choroidal cells
Ependymal cells
Spindle-shaped cells
Hemosiderin granules and hematoidin crystals are seen in:
Macrophages
Myeloblasts are seen in the CSF:
As a complication of acute leukemia
Cells resembling large and small lymphocytes with cleaved nuclei represent:
Lymphoma cells
The reference range for CSF protein is:
15 to 45 g/dL
CSF can be differentiated from serum by the presence of:
Globulin
In serum, the second most prevalent protein is IgG; in CSF, the second most prevalent protein is:
Prealbumin
Elevated CSF protein values can be caused by all of the following except:
Fluid leakage
The integrity of the blood–brain barrier is measured using the:
CSF/serum albumin index
Given the following results, calculate the IgG index: CSF IgG, 50 mg/dL; serum IgG, 2 g/dL; CSF albumin, 70 mg/dL; serum albumin, 5 g/dL.
1.8
The CSF IgG index calculated in Study Question 27 indicates:
Synthesis of IgG in the CNS
The finding of oligoclonal bands in the CSF and not in the serum is seen with:
Multiple sclerosis
A CSF glucose of 15 mg/dL, WBC count of 5000, 90% neutrophils, and protein of 80 mg/dL suggests:
Bacterial meningitis
A patient with a blood glucose of 120 mg/dL would have a normal CSF glucose of:
60 mg/dL
CSF lactate will be more consistently decreased in:
Bacterial meningitis
Measurement of which of the following can be replaced by CSF glutamine analysis in children with Reye syndrome?
Ammonia
Before performing a Gram stain on CSF, the specimen must be:
Centrifuged
All of the following statements are true about cryptococcal meningitis except:
The WBC count is over 2000
The test of choice to detect neurosyphilis is the:
FTA-ABS
Maturation of spermatozoa takes place in the:
Epididymis
Enzymes for the coagulation and liquefaction of semen are produced by the:
Prostate gland
The major component of seminal fluid is:
Fructose
If the first portion of a semen specimen is not collected, the semen analysis will have which of the following?
Decreased sperm count
Failure of laboratory personnel to document the time a semen sample is collected primarily affects the interpretation of semen:
Viscosity
Liquefaction of a semen specimen should take place within:
1 hour
A semen specimen delivered to the laboratory in a condom has a normal sperm count and markedly decreased sperm motility. This indicates:
Antispermicide in the condom
An increased semen pH may be caused by:
D. All of the above
Prostatic infection
Decreased prostatic secretions
Decreased bulbourethral gland secretions
Proteolytic enzymes may be added to semen specimens to:
Decrease the viscosity
The normal sperm concentration is:
More than 20 million/mL
Given the following information, calculate the sperm concentration: dilution, 1:20; sperm counted in five RBC squares on each side of the hemocytometer, 80 and 86; volume, 3 mL.
83 million/mL
Using the above information, calculate the sperm concentration when 80 sperm are counted in 1 WBC square and 86 sperm are counted in another WBC square.
16.6 million/mL
The primary reason to dilute a semen specimen before performing a sperm concentration is to:
Immobilize the sperm
When performing a sperm concentration, 60 sperm are counted in the RBC squares on one side of the hemocytometer and 90 sperm are counted in the RBC squares on the other side. The specimen is diluted 1:20. The:
Specimen should be rediluted and counted
Sperm motility evaluations are performed:
Within 1 hour of collection
The percentage of sperm showing average motility that is considered normal is:
50%
The purpose of the acrosomal cap is to:
Penetrate the ovum
The sperm part containing a mitochondrial sheath is the:
Midpiece
All of the following are associated with sperm motility except the:
Head
The morphologic shape of a normal sperm head is:
Oval
Normal sperm morphology when using the WHO criteria is:
> 30% normal forms
Additional parameters measured by Kruger’s strict morphology include all of the following except:
Vitality
Round cells that are of concern and may be included in sperm counts and morphology analysis are:
D. Both A and B
Leukocytes
Spermatids
If 5 round cells per 100 sperm are counted in a sperm morphology smear and the sperm concentration is 30 million, the concentration of round cells is:
1.5 million
Following an abnormal sperm motility test with a normal sperm count, what additional test might be ordered?
Eosin-nigrosin stain
Follow-up testing for a low sperm concentration would include testing for:
Seminal fluid fructose
The immunobead test for antisperm antibodies:
D. All of the above
Detects the presence of male antibodies
Determines the presence of IgG, IgM, and IgA antibodies
Determines the location of antisperm antibodies
Measurement of -glucosidase is performed to detect a disorder of the:
Epididymis
A specimen delivered to the laboratory with a request for prostatic acid phosphatase and glycoprotein p30 was collected to determine:
A possible rape
Following a negative postvasectomy wet preparation, the specimen should be:
Centrifuged and reexamined
Standardization of procedures and reference values for semen analysis is primarily provided by the:
WHO
The functions of synovial fluid include all of the following except:
Removal of cartilage debris
The primary function of synoviocytes is to:
Provide nutrients for the joints
Which of the following is not a frequently performed test on synovial fluid?
Uric acid
The procedure for collecting synovial fluid is called:
Arthrocentesis
Match the following disorders with their appropriate group:
____ Gout
____ Neisseria gonorrhoeaeinfection
____ Systemic lupus erythematosus
____ Osteoarthritis
____ Hemophilia
____ Rheumatoid arthritis
____ Heparin overdose
Noninflammatory
____ Osteoarthritis
Inflammatory
____ Gout
____ Systemic lupus erythematosus
____ Rheumatoid arthritis
Septic
____ Neisseria gonorrhoeaeinfection
Hemorrhagic
____ Hemophilia
____ Heparin overdose
Normal synovial fluid resembles:
Egg white
Before testing, very viscous synovial fluid should be treated with:
Hyaluronidase
Addition of a cloudy, yellow synovial fluid to acetic acid produces a/an:
Easily dispersed clot
Which of the following could be the most significantly affected if a synovial fluid is refrigerated before testing?
Crystal examination
The highest WBC count can be expected to be seen with:
Septic arthritis
When diluting a synovial fluid WBC count, all of the following are acceptable except:
Acetic acid
The lowest percentage of neutrophils would be seen in:
Noninflammatory arthritis
All of the following are abnormal when seen in synovial fluid except:
Synovial lining cells
Synovial fluid crystals that occur as a result of purine metabolism or chemotherapy for leukemia are:
Monosodium urate
Synovial fluid crystals associated with inflammation in dialysis patients are:
Calcium oxalate
Crystals associated with pseudogout are:
Calcium pyrophosphate dihydrate
Synovial fluid for crystal examination should be examined as a/an:
Wet preparation
Crystals that have the ability to polarize light are:
D. All of the above
Corticosteroid
Monosodium urate
Calcium oxalate
In an examination of synovial fluid under compensated polarized light, rhomboid-shaped crystals are observed. What color would these crystals be when aligned parallel to the slow vibration?
Yellow
If crystals shaped like needles are aligned perpendicular to the slow vibration of compensated polarized light, what color are they?
Negative
Negative birefringence occurs under red-compensated polarized light when:
Fast light runs against the molecular grain of the crystal
Synovial fluid cultures are often plated on chocolate agar to detect the presence of:
Neisseria gonorrhoeae
The most frequently performed chemical test on synovial fluid is:
Calcium
Which of the following chemistry tests can be performed on synovial fluid to determine the severity of RA?
Lactate
Serologic tests on patients’ serum may be performed to detect antibodies causing arthritis for all of the following disorders except:
Pseudogout
The primary purpose of serous fluid is to:
Lubricate serous membranes
The membrane that lines the wall of a cavity is the:
Parietal
During normal production of serous fluid, the slight excess of fluid is:
Absorbed by the lymphatic system
Production of serous fluid is controlled by:
D. All of the above
Capillary oncotic pressure
Capillary hydrostatic pressure
Capillary permeability
An increase in the amount of serous fluid is called a/an:
Effusion
Pleural fluid is collected by:
Thoracentesis
A. Transudate
B. Exudate
____ Caused by increased hydrostatic pressure
____ Caused by increased capillary permeability
____ Caused by decreased oncotic pressure
____ Caused by congestive heart failure
____ Malignancy related
____ Tuberculosis related
____ Endocarditis related
____ Clear appearance
A. Transudate
____ Caused by increased hydrostatic pressure
____ Malignancy related
____ Tuberculosis related
B. Exudate
____ Caused by increased capillary permeability
____ Caused by decreased oncotic pressure
____ Caused by congestive heart failure
____ Endocarditis related
____ Clear appearance
Fluid:serum protein and lactic dehydrogenase ratios are performed on serous fluids:
To classify transudates and exudates
Which of the following requires the most additional testing?
Exudate
An additional test performed on pleural fluid to classify the fluid as a transudate or exudate is the:
Fluid:cholesterol ratio
A milky-appearing pleural fluid indicates:
D. Both A and B
Thoracic duct leakage
Chronic inflammation
Which of the following best represents a hemothorax?
Blood HCT: 30 Fluid HCT: 20
All of the following are normal cells seen in pleural fluid except:
Mesothelioma cells
A differential observation of pleural fluid associated with tuberculosis is:
Decreased mesothelial cells
All of the following are characteristics of malignant cells except:
Absence of nucleoli
A pleural fluid pH of 6.0 indicates:
Esophageal rupture
Plasma cells seen in pleural fluid indicate:
Tuberculosis infection
A significant cell found in pericardial or pleural fluid that should be referred to cytology is a:
Mesothelioma cell
Another name for a peritoneal effusion is:
Ascites
A test performed primarily on peritoneal lavage fluid is a/an:
RBC count
The recommended test for determining whether peritoneal fluid is a transudate or an exudate is the:
Serum ascites albumin gradient
Given the following results, classify this peritoneal fluid: serum albumin, 2.2 g/dL; serum protein, 6.0 g/dL; fluid albumin, 1.6 g/dL.
Exudate
Differentiation between bacterial peritonitis and cirrhosis is done by performing a/an:
Absolute neutrophil count
Detection of the CA 125 tumor marker in peritoneal fluid indicates:
Ovarian cancer
Chemical tests primarily performed on peritoneal fluid include all of the following except:
Amylase
Cultures of peritoneal fluid are incubated:
D. Both A and B
Aerobically
Anaerobically
Which of the following is not a function of amniotic fluid?
Allows carbon dioxide and oxygen exchange
What is the primary cause of the normal increase in amniotic fluid as a pregnancy progresses?
Fetal urine
Which of the following is not a reason for decreased amounts of amniotic fluid?
Fetal failure to begin swallowing
Why might a creatinine level be requested on an amniotic fluid?
Differentiate amniotic fluid from maternal urine
Amniotic fluid specimens are placed in amber-colored tubes prior to sending them to the laboratory to prevent the destruction of:
Bilirubin
How are specimens for FLM testing delivered to and stored in the laboratory?
Delivered on ice and refrigerated
Why are amniotic specimens for cytogenetic analysis incubated at 37°C prior to analysis?
To prolong fetal cell viability and integrity
Fetal death
Red-brown
Normal
Colorless
Presence of bilirubin
Yellow
Presence of meconium
Dark green
A significant rise in the OD of amniotic fluid at 450 nm indicates the presence of which analyte?
Bilirubin
Plotting the amniotic fluid OD on a Liley graph represents the severity of hemolytic disease of the newborn. A value that is plotted in zone II indicates what condition of the fetus?
Moderately affected fetus that requires close monitoring
The presence of a fetal neural tube disorder may be detected by:
Increased maternal serum alpha-fetoprotein
True or False: An AFP MoM value greater than two times the median value is considered an indication of a neural tube disorder.
T
When severe HDN is present, which of the following tests on the amniotic fluid would the physician not order to determine whether the fetal lungs are mature enough to withstand a premature delivery?
AFP levels
When performing an L/S ratio by thin-layer chromatography, a mature fetal lung will show:
Lecithin twice as concentrated as sphingomyelin
True or False: Phosphatidyl glycerol is present with an L/S ratio of 1.1.
T
A rapid immunologic test for FLM that does not require performance of thin-layer chromatography is:
Aminostat-FLM
Does the failure to produce bubbles in the Foam Stability Index indicate increased or decreased lecithin?
Decreased
The presence of phosphatidyl glycerol in amniotic fluid fetal lung maturity tests must be confirmed when:
The mother has maternal diabetes
A lamellar body count of 50,000 correlates with:
OD at 650 nm of 0.150 and an L/S ratio of 2.0
In what part of the digestive tract do pancreatic enzymes and bile salts contribute to digestion?
.Small intestine
Where does the reabsorption of water take place in the primary digestive process?
Large intestine
Which of the following tests is notperformed to detect osmotic diarrhea?
Fecal neutrophils
The normal composition of feces includes all of the following except:
Blood
What is the fecal test that requires a 3-day specimen? A.Fecal occult blood
Quantitative fecal fat testing
The normal brown color of the feces is produced by:
Urobilin
Diarrhea can result from all of the following except:
Increased reabsorption of intestinal water and electrolytes
Stools from persons with steatorrhea will contain excess amounts of:
Fat
Which of the following pairings of stool appearance and cause does notmatch?
Yellow-green: barium sulfate
Stool specimens that appear ribbon-like are indicative of which condition?
Intestinal constriction
A black tarry stool is indicative of:
Upper GI bleeding
Chemical screening tests performed on feces include all of the following except:
Pilocarpine iontophoresis
Secretory diarrhea is caused by:
Vibrio cholerae
The fecal osmotic gap is elevated in which disorder?
Osmotic diarrhea
Microscopic examination of stools provides preliminary information as to the cause of diarrhea because:
Neutrophils are present in conditions that affect the intestinal wall
True or False: The presence of fecal neutrophils would be expected with diarrhea caused by a rotavirus.
F
Large orange-red droplets seen on direct microscopic examination of stools mixed with Sudan III represent:
Neutral fats
Microscopic examination of stools mixed with Sudan III and glacial acetic acid and then heated will show small orange-red droplets that represent:
Fatty acids, soaps, and neutral fats
When performing a microscopic stool examination for muscle fibers, the structures that should be counted:
Have two-dimensional striations
A value of 85% fat retention would indicate:
Steatorrhea
Which of the following tests would not be indicative of steatorrhea?
Fecal occult blood
The term “occult” blood describes blood that:
Is not visibly apparent in the stool specimen
What is the recommended number of samples that should be tested to confirm a negative occult blood result?
Two samples taken from different parts of three stools
The immunochemical tests for occult blood:
Test for human globulin
Guaiac tests for detecting occult blood rely on the:
Pseudoperoxidase activity of hemoglobin
What is the significance of an APT test that remains pink after addition of sodium hydroxide?
Fetal hemoglobin is present.
In the Van de Kamer method for quantitative fecal fat determinations, fecal lipids are:
Converted to fatty acids prior to titrating with sodium hydroxide
A patient whose stool exhibits increased fats, undigested muscle fibers, and the inability to digest gelatin may have:
Cystic fibrosis
A stool specimen collected from an infant with diarrhea has a pH of 5.0. This result correlates with a:
Positive Clinitest
Which of the following tests differentiates a malabsorption cause from a maldigestion cause in steatorrhea?
D-xylose test
All states require newborn screening for PKU for early:
Modifications of diet
All of the following disorders can be detected by newborn screening except:
Melanuria
The best specimen for early newborn screening is a:
Blood specimen
Abnormal urine screening tests categorized as an overflow disorder include all of the following except:
Melanuria
Which of the following disorders is not associated with the phenylalanine-tyrosine pathway?
MSUD
The least serious form of tyrosylemia is:
Immature liver function
An overflow disorder of the phenylalanine-tyrosine pathway that would produce a positive reaction with the reagent strip test for ketones is:
MSUD
An overflow disorder that could produce a false-positive reaction with Clinitest procedure is:
Alkaptonuria
A urine that turns black after sitting by the sink for several hours could be indicative of:
A. Alkaptonuria
C. Melanuria
Ketonuria in a newborn is an indication of:
A. MSUD B. Isovaleric acidemia C. Methylmalonic acidemia
Urine from a newborn with MSUD will have a significant:
Sweet odor
Hartnup disease is a disorder associated with the metabolism of:
Tryptophan
. 5-HIAA is a degradation product of:
Serotonin
Elevated urinary levels of 5-HIAA are associated with:
Carcinoid tumors
False-positive levels of 5-HIAA can be caused by a diet high in:
Bananas
IEM
Cystinosis
Inherited disorder of tubular reabsorption
Cystinuria
Fanconi syndrome
Cystinosis
Cystine deposits in the cornea
Cystinosis
Early renal calculi formation
Cystinuria
Blue diaper syndrome is associated with:
Hartnup disease
Homocystinuria is caused by failure to metabolize:
Methionine
The Ehrlich reaction will only detect the presence of:
Porphobilinogen
Acetyl acetone is added to the urine before performing the Ehrlich test when checking for:
Porphobilinogen
The classic urine color associated with porphyria is:
Port wine
Which of the following specimens can be used for porphyrin testing?
A. Urine B. Blood C. Feces
The two stages of heme formation affected by lead poisoning are:
Aminolevulinic acid and protoporphyrin
Hurler, Hunter, and Sanfilippo syndromes are hereditary disorders affecting metabolism of:
Mucopolysaccharides
Many uric acid crystals in a pediatric urine specimen may indicate:
Lesch-Nyhan disease
Deficiency of the GALT enzyme will produce a:
A. Positive Clinitest
C. Galactosemia
PKU
Mousy odor
Indicanuria
Blue color
Cystinuria
Sulfur odor
Alkaptonuria
Black color
Lesch-Nyhan disease
Orange sand in diaper
Isovaleric acidemia
Sweaty feet odor
Most glomerular disorders are caused by:
Immunologic disorders
Dysmorphic RBC casts would be a significant finding with all of the following except:
Chronic pyelonephritis
Occasional episodes of macroscopic hematuria over periods of 20 or more years are seen with:
IgA nephropathy
Antiglomerular basement membrane antibody is seen with:
Goodpasture syndrome
Antineutrophilic cytoplasmic antibody is diagnostic for:
Wegener granulomatosis
Respiratory and renal symptoms are associated with all of the following except:
Goodpasture syndrome
The presence of fatty casts is associated with all of the following except:
Nephrogenic diabetes insipidus
The highest levels of proteinuria are seen with:
Nephrotic syndrome
Ischemia frequently produces
Acute renal tubular necrosis
A disorder associated with polyuria and low specific gravity is:
Nephrogenic diabetes insipidus
An inherited disorder producing a generalized defect in tubular reabsorption is:
Fanconi syndrome
A teenage boy who develops gout in his big toe and has a high serum uric acid should be monitored for:
Uromodulin-associated kidney disease
The only protein produced by the kidney is:
Uromodulin
The presence of renal tubular epithelial cells and casts is an indication of:
Acute tubular necrosis
Differentiation between cystitis and pyelonephritis is aided by the presence of:
WBC casts
The presence of WBCs and WBC casts with no bacteria is indicative of:
Acute interstitial nephritis
End-stage renal disease is characterized by all of the following except:
Hypersthenuria
Prerenal acute renal failure could be caused by:
Massive hemorrhage
The most common composition of renal calculi is:
Calcium oxalate
Urinalysis on a patient with severe back pain being evaluated for renal calculi would be most beneficial if it showed:
Microscopic hematuria
Macroscopic screening of urine specimens is used to:
Provide results as soon as possible
Variations in the microscopic analysis of urine include all of the following except:
Identification of formed elements
All of the following can cause false-negative microscopic results except:
Dilute alkaline urine
The two factors that determine relative centrifugal force are:
Diameter of rotor head and rpm
When using the glass slide and cover-slip method, which of the following might be missed if the cover slip is overflowed?
Casts
Initial screening of the urine sediment is performed using an objective power of:
10×
Which of the following should be used to reduce light intensity in bright-field microscopy?
Rheostat
Which of the following are reported as number per lpf?
Casts
The Sternheimer-Malbin stain is added to urine sediments to do all of the following except:
Decrease precipitation of crystals
Nuclear detail can be enhanced by:
B. Toluidine blue C. Acetic acid
Which of the following lipids is/are stained by Sudan III?
B. Neutral fats C. Triglycerides
Which of the following lipids is/are capable of polarizing light?
Cholesterol
The purpose of the Hansel stain is to identify:
Eosinophils
Crenated RBCs are seen in urine that is:
Hypersthenuric
Differentiation among RBCs, yeast, and oil droplets may be accomplished by all of the following except:
Lysis of yeast cells by acetic acid
A finding of dysmorphic RBCs is indicative of:
Glomerular bleeding
Leukocytes that stain pale blue with Sternheimer-Malbin stain and exhibit brownian movement are:
Glitter cells
Mononuclear leukocytes are sometimes mistaken for:
Renal tubular cells
When pyuria is detected in a urine sediment, the slide should be carefully checked for the presence of:
Bacteria
Transitional epithelial cells are sloughed from the:
Bladder
The largest cells in the urine sediment are:
Squamous epithelial cells
A clinically significant squamous epithelial cell is the:
Clue cell
Forms of transitional epithelial cells include all of the following except:
Convoluted
Increased transitional cells are indicative of:
A. Catheterization B. Malignancy
A primary characteristic used to identify renal tubular epithelial cells is:
Eccentrically located nucleus
Following an episode of hemoglobinuria, RTE cells may contain:
Hemosiderin granules
The predecessor of the oval fat body is the:
Renal tubular cell
A structure believed to be an oval fat body produced a Maltese cross formation under polarized light but does not stain with Sudan III. The structure:
Contains cholesterol
The finding of yeast cells in the urine is commonly associated with:
Diabetes mellitus
The primary component of urinary mucus is:
Uromodulin
The majority of casts are formed in the:
Distal convoluted tubules
Cylindruria refers to the presence of:
All types of casts
A person submitting a urine specimen following a strenuous exercise routine can normally have all of the following in the sediment except:
WBC casts
Prior to identifying an RBC cast, all of the following should be observed except:
Intact RBCs in the cast
WBC casts are primarily associated with:
Pyelonephritis
The shape of the RTE cell associated with renal tubular epithelial casts is primarily:
Round
When observing RTE casts, the cells are primarily:
Embedded in a clear matrix
The presence of fatty casts is associated with:
A. Nephrotic syndrome B. Crush injuries C. Diabetes mellitus
Nonpathogenic granular casts contain:
Cellular lysosomes
All of the following are true about waxy casts except they:
Require staining to be visualized
Observation of broad casts represents:
A. Destruction of tubular walls
C. Formation in the collecting ducts
All of the following contribute to urinary crystals formation except:
Protein concentration
The most valuable initial aid for identifying crystals in a urine specimen is:
pH
Crystals associated with severe liver disease include all of the following except:
Cystine
All of the following crystals routinely polarize except:
Cystine
Casts and fibers can usually be differentiated using:
Polarized light
Envelopes
Calcium oxalate dihydrate
Yellow-brown, whetstone
Uric acid
Pink sediment
Amorphous urates
Ovoid
Calcium oxalate monohydrate
Thin prisms
Calcium phosphate
“Coffin lids”
Triple phosphate
Dumbbell shape
Calcium carbonate
White precipitate
Amorphous phosphate
Thorny apple
Ammonium biurate
Bundles following refrigeration
Ampicillin
Bright yellow clumps
Bilirubin
Hexagonal plates
Cystine
Flat plates, high specific gravity
Radiographic dye
Concentric circles, radial striations
Leucine
Notched corners
Cholesterol
Fine needles seen in liver disease
Tyrosine
Indirect light is reflected off the object
Dark-field
Objects split light into two beams
Polarized
Low refractive index objects may be overlooked
Bright-field
Three-dimensional images
Interference contrast
Forms halo of light around object
Phase
The concentration of a normal urine specimen can be estimated by which of the following?
Color
The normal yellow color of urine is produced by:
Urochrome
The presence of bilirubin in a urine specimen produces a:
Yellow foam when shaken
A urine specimen containing melanin will appear:
Black
Specimens that contain hemoglobin can be visually distinguished from those that contain RBCs because:
Hemoglobin produces a clear, yellow specimen
A patient with a viscous orange specimen may have been:
Treated for a urinary tract infection
The presence of a pink precipitate in a refrigerated specimen is caused by:
Uroerythrin
Microscopic examination of a clear urine that produces a white precipitate after refrigeration will show:
Amorphous phosphates
The color of urine containing porphyrins will be:
Port wine
Which of the following specific gravities would be most likely to correlate with a pale yellow urine?
1.005
A urine specific gravity measured by refractometer is 1.029, and the temperature of the urine is 14°C. The specific gravity should be reported as:
1.029
The principle of refractive index is to compare:
Light velocity in air with light velocity in solutions
A correlation exists between a specific gravity by refractometer of 1.050 and a:
Radiographic dye infusion
A cloudy urine specimen turns black upon standing and has a specific gravity of 1.012. The major concern about this specimen would be:
Color
A specimen with a specific gravity of 1.035 would be considered:
Hypersthenuric
A specimen with a specific gravity of 1.001 would be considered:
Not urine
A strong odor of ammonia in a urine specimen could indicate:
An old specimen
The microscopic of a clear red urine is reported as many WBCs and epithelial cells. What does this suggest?
Possible mix-up of specimen and sediment
Which of the following would contribute the most to a urine osmolality?
One osmole of sodium chloride
Which of the following colligative properties is not stated correctly?
The freezing point is raised by solute
An osmole contains:
One gram molecular weight of solute dissolved in one kilogram of solvent
The unit of osmolality measured in the clinical laboratory is the:
Osmole
In the reagent strip specific gravity reaction the polyelectrolyte:
Releases hydrogen ions in response to ion concentration
Which of the following will react in the reagent strip specific gravity test?
Chloride
Leaving excess urine on the reagent strip after removing it from the specimen will:
Cause run-over between reagent pads
Failure to mix a specimen before inserting the reagent strip will primarily affect the:
B.Blood reading C.Leukocyte reading
Testing a refrigerated specimen that has not warmed to room temperature will adversely affect:
Enzymatic reactions
The reagent strip reaction that requires the longest reaction time is the:
Leukocyte esterase
Quality control of reagent strips is performed:
A. Using positive and negative controls B. When results are questionable C. At least once every 24 hours
All of the following are important to protect the integrity of reagent strips except:
Removing the desiccant from the bottle
The principle of the reagent strip test for pH is the:
Double indicator reaction
A urine specimen with a pH of 9.0:
Should be recollected
In the laboratory, a primary consideration associated with pH is:
A. Identifying urinary crystals
C. Determining specimen acceptability
Microalbuminuria
renal
Acute phase reactants
prerenal
Pre-eclampsia
renal
Vaginal inflammation
postrenal
Multiple myeloma
prerenal
Orthostatic proteinuria
renal
Prostatitis
postrenal
The principle of the protein error of indicators reaction is that:
Albumin accepts hydrogen ions from the indicator
All of the following will cause false-positive protein reagent strip values except:
Microalbuminuria
A patient with a 2+ protein reading in the afternoon is asked to submit a first morning specimen. The second specimen has a negative protein reading. This patient is:
Positive for orthostatic proteinuria
Testing for microalbuminuria is valuable for early detection of kidney disease and monitoring patients with:
A. Hypertension B. Diabetes mellitus C. Cardiovascular disease risk
The primary chemical on the reagent strip in the MicralTest for microalbumin binds to:
Antihuman albumin antibody
All of the following are true for the ImmunoDip test for microalbumin except:
Unbound antibody migrates farther than bound antibody
The principle of the protein-high pad on the Multistix Pro reagent strip is the:
Protein error of indicators
Which of the following is not tested on the Multistix Pro reagent strip?
Urobilinogen
The principle of the protein-low reagent pad on the Multistix Pro is the:
Binding of albumin to sulphonphthalein dye
The principle of the creatinine reagent pad on microalbumin reagent strips is the:
Diazo reaction
The purpose of performing an albumin:creatinine ratio is to:
Estimate the glomerular filtration rate
A patient with a normal blood glucose and a positive urine glucose should be further checked for:
Renal disease
The principle of the reagent strip tests for glucose is the:
Double sequential enzyme reaction
All of the following may produce false-negative glucose reactions except:
Detergent contamination
The primary reason for performing a Clinitest is to:
Check for newborn galactosuria
The three intermediate products of fat metabolism include all of the following except:
Ketoacetic acid
The most significant reagent strip test that is associated with a positive ketone result is:
Glucose
The primary reagent in the reagent strip test for ketones is:
Sodium nitroprusside
Ketonuria may be caused by all of the following except:
Bacterial infections
Urinalysis on a patient with severe back and abdominal pain is frequently performed to check for:
Hematuria
Associated with transfusion reactions
Hemoglobinuria
Clear red urine and pale yellow plasma
Myoglobinuria
Clear red urine and red plasma
Hemoglobinuria
Associated with rhabdomyolysis
Myoglobinuria
Produces hemosiderin granules in urinary sediments
Hemoglobinuria
Associated with acute renal failure
Myoglobinuria
The principle of the reagent strip test for blood is based on the:
Peroxidase activity of heme
A speckled pattern on the blood pad of the reagent strip indicates:
Hematuria
List the following products of hemoglobin degradation in the correct order by placing numbers 1 to 4 in the blank.
- Conjugated bilirubin
- Unconjugated bilirubin
- Urobilinogen and stercobilinogen
- Urobilin
The principle of the reagent strip test for bilirubin is the:
Diazo reaction
An elevated urine bilirubin with a normal urobilinogen is indicative of:
Biliary obstruction
The primary cause of a false-negative bilirubin reaction is:
Specimen exposure to light
The purpose of the special mat supplied with the Ictotest tablets is that:
Bilirubin remains on the surface of the mat.
The reagent in the Multistix reaction for urobilinogen is:
p-Dimethylaminobenzaldehyde
The primary problem with urobilinogen tests using Ehrlich reagent is:
Positive reactions with porphobilinogen
The reagent strip test for nitrite uses the:
Ehrlich reaction
All of the following can cause a negative nitrite reading except:
Gram-negative bacteria
A positive nitrite test and a negative leukocyte esterase test is an indication of a:
Specimen older than 2 hours
All of the following can be detected by the leukocyte esterase reaction except:
Lymphocytes
Screening tests for urinary infection combine the leukocyte esterase test with the test for:
Nitrite
The principle of the leukocyte esterase reagent strip test uses a:
Diazo reaction
The principle of the reagent strip test for specific gravity uses the dissociation constant of a(n):
Polyelectrolyte
A specific gravity of 1.005 would produce the reagent strip color:
Blue
Reagent strip–specific gravity readings are affected by:
Alkaline urine
